Together at the Poles

How To Talk To Someone Who Has Bipolar Disorder


I may be a little controversial with this post, but bear with me. Part of the reason for stigma around bipolar disorder is that we can be a little different when symptomatic, and people aren’t quite sure how to talk with us during those periods. I know for myself, irritability, depression and especially effusiveness can create some socially awkward situations. As a result, we can be ignored or even disliked in some cases.

Conversation includes a number of complex social cues and skills. Bipolar disorder interferes with our ability to recognize those cues or to use those skills. However, if you know that you are speaking to someone with bipolar disorder and are at least vaguely aware of what kind of episode that person is in, there are reasonable accommodations that can be made, depending on what symptoms are involved. So, I’ve put together some thoughts about how best to relate to us during our symptomatic episodes.

The First Principles

The first principles of conversation are the same, regardless of whether or not someone is symptomatically bipolar. Basically, we want to connect with other people, learn about things, and enjoy each other’s company. Nothing about this changes when we are talking with someone who is symptomatically bipolar. The reason that I bring this up is that the goal here isn’t to create situations where the bipolar person feels patronized or “put up with.” These accommodations are intended to be no more patronizing than any other accommodations. The goal is simply to genuinely connect and enjoy the company of bipolar people when they are symptomatic.

Conversations During Hypomania

During hypomania, there are really two symptoms that are especially relevant to having conversations with someone who is bipolar. First, people who are bipolar are effusive. That means that we have the tendency to just talk about whatever is on our mind without the normal filters that people have. In my own experience, this isn’t a matter of losing the rudeness filters (usually). It’s rather a matter of losing inhibitions that might make me embarrassed to talk about the minutiae of my personal interests.

Second, people who are hympomanic tend to make a lot of very fast logical connections. Some of these are good connections, while some of them are bad connections. However, we will often simply go from one to the other without making them explicit. This can make it difficult to follow our reasoning.

So, how then should one speak with a bipolar person who is hypomanic? The goal here is simply to take advantage of the state, rather than to see it as a bad thing.

Effusiveness provides people with an opportunity to discuss things with bipolar people that they otherwise not get a chance to discuss. One of the things a lot of bipolar people have come to realize is that minutiae are very interesting. Bipolar people tend to know a lot about whatever it is that enthuses them, and there is a real opportunity to learn about and discover some new things by speaking with us.

In addition, people with bipolar disorder are more likely to be interested in the minutiae of whatever it is that you are talking about. So, if you have a hobby or interest that no one else much cares about, someone who is hypomanic is in the position to appreciate it. The appreciation is genuine. I know that when I “come down” from a hypomanic episode, I never lose the sense that the wonderfulness of things that I had appreciated were actually wonderful.

Now, there are a couple of just straight out strategies to bear in mind when speaking to someone who is hypomanic. First, feel free to simply cut us off. The need to keep talking can actually become a little compulsive, so to have a conversation, you’ll need to just break in there. We’re probably going to miss any subtle cues. Plus, we (or at least I) really want you to talk. Few things make me feel more embarrassed than going on about some subject for half an hour without any actual response.

In terms of the leaps of logic, one of the best things to do in order to have an interesting conversation with someone who is hypomanic is to simply ask a lot of questions. If something doesn’t seem to follow from something else, you can just ask how it does. Or, you can offer a different interpretation of how things connect, or ask for definitions, and so forth. This keeps the conversation going, and prevents you from getting lost when speaking to someone who is bipolar.

Dealing With Irritability

Often, people who are hypomanic are irritable, and having conversations with an irritable person can be very tricky. First, remember that you have no obligation to get snapped at or treated poorly. If you are speaking to someone who is becoming verbally abusive, feel free to simply tell them to stop or else leave the conversation.

There are, however, things that can be done when speaking to someone who is irritable to prevent things from becoming uncomfortable. The first is to recognize that the person is sensitive, and to therefore avoid topics that can become heated. In general, politics and religion are topics to be avoided in groups, anyway, but it becomes especially important if someone who is symptomatically irritable is thrown into the mix.

In addition, in my own experience, the best topics to talk about when irritable are those that have absolutely nothing to do with me. Irritability is a kind of hypersensitivity to perceived injustices, so staying away from topics where injuries are even possible is a good strategy. Discussions like why Firefly was such a great television show or backgammon strategy are examples of really interesting topics (varied to taste) that can be held perfectly well even with someone who is irritable.

Depression

Having conversations with people who are depressed can be quite a different matter (and applies to people with major depressive disorder, not just bipolar people). People who are depressed may not even want to have a conversation, and if they express that wish, the clichéd strategy is the best one. Just leave them alone, but extend the offer to speak with them later if they wish. This makes depressed people feel cared about while respecting their boundaries.

Depression causes the opposite of effusiveness, which is… “defusiveness”? I’m not sure of the word, but the basic point is that people with depression are often not very good at holding up their end of the conversation. This leads a lot of people to simply give up, and to go away. However, there are some fairly straightforward accommodations that one can make.

John George Brown - Sympathy

Public Domain

One warning is to not simply pepper a depressed person with many questions. It’s usually counter-productive. You want the person to want to speak with you, not feel obliged to speak to you because the conventions of conversation require it. Lots of questions just puts the person on the spot, which makes them want to speak less, not more.

Instead, see if the person actually wants to talk about something that is making that person sad. If there is something, usually a “are things going okay?” will usually bring up the subject rather quickly. If there is something, ask questions, offer advice only when asked for it and offer support.

However, with bipolar disorder, we are often depressed from no circumstance whatsoever. Instead, we are simply “down.” In these cases, conversation can be a great way of improving our mood, at least temporarily. In this case, the goal is to focus on genuinely enjoying each other’s company in spite of the depressive mood.

Everyone has subjects that they can discuss endlessly, even if they are not effusive. Assuming you know the depressed person well enough to know what some of them are, why not start a conversation about one of those subjects? Just make sure it’s one that you find interesting as well. The goal here isn’t to “cheer the person up,” at least not directly. The goal is to enjoy each other’s conversation.

You’ll probably end up doing a lot of the talking, but just like it’s hard to drive and talk on a cell phone at the same time, it’s hard to focus on one’s depression and have a conversation about something completely unrelated at the same time. It won’t get rid of the depression, as that’s something wrong with our brains, but it will provide some genuine enjoyment in the meantime.

Conclusion

Having conversations with symptomatic bipolar people can be difficult, since bipolar disorder can disrupt conversational skills. Instead, there are a few accommodations that can be made, depending on the symptoms involved. Conversations with hypomanic people can be especially dynamic and interesting, while conversations with those in other states can still be opportunities for connecting with people and enjoying their company.

21 Responses to How To Talk To Someone Who Has Bipolar Disorder

  • I am also bipolar. Your points are not at all controversial. To the contrary, I would say…points well made AND well taken. :)

  • I have seen your posts before but never actually stopped to read one and for some reason tonight this post jumped at me to read it. I have bipolar along with my teenage son and I loved this! I am actually hopeful if I can print and give to some of the people I am close with in my life it will help them understand what it is like for me and that it is normal to need some accomodations when symptomatic!

    Thank you for the wonderful post!!!

    • You’re welcome, Angela. I hadn’t thought of printing this off and giving it to people, but you’re right. It would be a good way to let people know just what it is we need in conversation. Thank you for the idea :)

  • lBLN6988soEx
    Thank you so much for this info, I found this so very helpful for myself, having bipolar, with add-on’s also, it took my Dr’s over 10yrs to find my disorder – hence the add-on’s – I have been trying to get my Dr’s to diagnose my now, 16yr old daughter, but they wont, because she is still a teenager. We live in Australia, an for some reason think it is just her being a Teen, but she is getting worse with her mood swings, aggression towards herself, me an objects – like my doors etc… I read alot of your links/pages it helps so very much, my friends have told me with what goes on in my (oh an btw, i dont go anywhere, i stay home an very rarely go anywhere) – our lives i should be writting a book, LOL – they believe, with what i can share i would help so many others like me, us – my response is normally…. yes i could, but where on earth would i start, lol 😀
    Also a question i have wanted to ask you, Daniel, i love to do art work, draw, sketch, paint etc.., i have seen people put it on your pages or their own, how do you do that? – i know probably a silly question, but i am new to getting things put from paper to computer LOL 😀 thank -you an Blessed Be,
    K

    • Thanks for your comment, Kim :). I know that outside North America, people are far more hesitant to diagnose minors with bipolar disorder, so that may be what you are facing. If you haven’t, it might be worth getting a referral to an psychiatrist for your daughter, or just hiring one yourself if you can afford it.

      For artwork, you can e-mail it to me at submissions@bipolarvillage.com. I’ve just started a gallery.

  • Hi, I agree with Daniel, Kim, maybe it would be a good idea for your daughter to see a psychiatrist. Even if she isn’t given an official diagnosis maybe the Dr can help in some/any ways. I live in Australia too :) Daniel..thanks so much for this site.

  • I had seen this posted on facebook and it was very enlightning…I am bipolar II along with borderline personality disorder panic axiety and ocd. I myself can see that when I am in these stages it can be any little thing that can set me off and its hard escpecially for me to understand why I get that way. This is a great article and it would be nice if everyone would read up on being bipolar. Its a difficult “condition” and can be very distructive for ourselves. Thank you so much for sharing :)

  • As was said previously, I did not find any of this controversial. You simply and tactfully gave recommendations for both sides of the conversations and, being bipolar, I wasn’t offended at all. Very well written!

    • Thanks, Jonathan. I think my main concern was that people might find this patronizing, but it sounds like it didn’t come across that way at all :).

  • This is one of those posts I wish I’d found sooner, but I’m very glad to have found it now. If I’d found it prior to a few weeks ago, I might have been better prepared for my husband’s first bought of hypomania; at least the first one I’ve ever witnessed. We’ve been together for 7 years, but mostly he fights with with episodes of depression, along with one major mixed episode. Any mania he experienced prior to this was very mild in comparison during the time that we’ve been together. I wasn’t prepared for the onslaught of ideas, his rapid rate of speech, his need to have an outlet for all of that vast energy. In some ways it could have even been a little fun, had we not both been worried that it might launch another mixed episode. Had I realized a great way to help him would be to direct him to one of the many subjects he’s so passionate about, I’m sure it would have helped us both to get through it more easily. Having read this, I feel more prepared the next time this comes around.

    I have a couple of questions: First, we were supposed to go to a party that evening and canceled it. We did this because historically he has difficulties dealing with people when he’s experiencing symptoms. It creates a lot of anxiety for him. I wonder though, if more people to talk with would have been a benefit in this case? Second, the episode began with insomnia. He wasn’t able to sleep for two days and only managed to sleep once he was coming down. Do you experience this and do you have any advice about it?

    Thanks so much for your blog and all you put into it. My husband and I both find it helpful and enjoyable. I always find first hand accounts more useful than most psych literature out there. Thanks!

    • You’re welcome, Michelle. First, in my own experience, I find that I’d rather just avoid social situations when symptomatic. Even if I don’t embarrass myself, I still find the whole thing very stressful. I wrote a little bit about my experiences here.

      Insomnia is extremely common with hypomania and mania. I tend to get a lot less sleep, though not complete sleeplessness. Your husband may want to speak to a psychiatrist about sleep aids. Just about anything that affects our brain can potentially create problems, so I would never try anything without going through my psychiatrist first. In my last episode, which was at the beginning of August, my psychiatrist prescribed me some sleeping pills, and it was really helpful. The lack of sleep itself can exacerbate an episode.

  • Thank you so very much for this article. I was diagnosed with Bipolar disorder about 4 ears ago. I have gone to the psychiatrist on and off for 20 years. Been put on many different meds thru the years. Not until 4 years ago was I diagnosed with Bipolar disorder, depression and anxiety. Lately I’ve been trying to understand my Illness and have been reading quite a bit about this Illness to educate myself. Depending on what kind of day I’m having, at times I tell people please feel free to stop me if I start to ramble onI saw your link on facebook and I’m glad I checked it out.

  • March of this year my husband was diagnosed with bipolar disorder , manic depression ,panic disorder and heavy anxiety ,they may fall all under the one disorder or not i am very new to this and conversations with my husband are very strained at times .Shortly after my husbands diagnosis our son was diagnosed with the disorder as well but his mood swings are way more intense and he can be extremely violent , but with the meds he is doing sooo much better ,my husband is still struggling with the fact that he has this and that he will be taking meds from now on he is not happy about it ,he has had to go on disability and desperately wants to go back to work but doesn’t have the confidence yet! We are hopeful , at least I am !

    • Thank you for sharing this, Janice. I’m glad to hear you have hope with the two diagnoses in your family.

  • I’ve lived with a bipolar mother my entire life (i’m in my 40’s now) & I STILL live with her….she can’t be alone. She won’t take her meds, she won’t drive, she is retired, but doesn’t work, she’s fanatically religious & impossible. She has run up behind me as I was walking away and kicked me in the back and has run up behind me & pulled my hair; and when you have to have a family member live with you besides the ill person….just to keep the two of you from KILLING each other, it’s a lost cause. Of course, she’s not only bipolar….she’s supposed to be on a combo drug, one part of which is prescribed for schizophrenics, and the other which is an anti-depressant for during the crash periods of the bipolar. I’m near to calling the men in white coats to throw her into a rubber room. So tired of it.

  • Thanks for the article. My mother has bipolar and has been on a “high” now for several months after refusing to take her medication and denying she has any disorder. Speaking to her just goes round and round with no logic coming out of her mouth whatsoever. Not sure what to do as she just says whatever she likes regardless of what we are talking about. She often makes comments like “I’ll take care of them” and similar. This worries me. Can you possibly recommend an approach to take as I’m out of ideas?

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Counselling from Daniel
Daniel Bader, Ph.D., RSW, CCC
Daniel Bader, Ph.D., RSW, CCC is a Registered Social Worker and Canadian Certified Counsellor with a private practice operating out of Kitchener, Ontario. He provides in-person counselling in Kitchener and email, video or telephone counselling within Canada.

To find out more, please visit the website for his private practice, Bader Mediation & Counselling Services.